Grounds for euthanasia expand in Belgium, where legislators are also challenging the right of doctors and hospitals to say ‘No’ to doctor-directed death.

BY CELESTE MCGOVERN

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Posted 2/11/13 at 9:12 AM

JETTE, Belgium — Marc and Eddy Verbessem dressed in their new suits and shoes, had a cup of coffee and said goodbye to their parents and brother for the last time. Then the 45-year-old identical twin brothers gave a last little wave, and “they were gone,” said the doctor who gave them both lethal injections in December at the Brussels University Hospital in Jette, Belgium.

Born deaf, the brothers had lived together their entire lives, sharing a small apartment and working as cobblers in the village of Putte near Antwerp. When they were diagnosed nearly two years ago with a rare form of congenital glaucoma and told that they would eventually go blind, they sought euthanasia in Belgium, where it has been legal since 2002.

The brothers’ case has drawn worldwide attention because they were not suffering a terminal illness, and they were not in unbearable pain. Yet they met the criteria for legal euthanasia in Belgium, a fact that pro-lifers say graphically highlights how lax interpretation of the euthanasia law has become. Days after their deaths were reported to the media in January, the Socialist government introduced legislation that would further liberalize euthanasia, allowing minors and demented patients, such as those suffering with Alzheimer’s, to have doctors kill them.

“Many will wonder why my brothers have opted for euthanasia because there are plenty of deaf and blind people that have a normal life,” the twins’ 46-year-old brother Dirk Berbessem told reporters. “But my brothers trudged from one disease to another. They were really worn out.”

But the fear of loss of independency and institutionalization, not their ill health, was the tipping point.

“The great fear that they would no longer be able to hear and see each other and the family was, for my brothers, unbearable,” he said.

Belgian Law

Belgian law states that euthanasia is permissible if “a patient is in a medically futile condition of constant and unbearable physical or mental suffering that cannot be alleviated, resulting from a serious and incurable disorder caused by illness or accident.”

The consulting physician is supposed to have “come to the belief that there is no reasonable alternative to the patient’s situation and that the patient's request is completely voluntary.”

The Verbessem brothers’ first request for euthanasia at their local hospital was turned down. “If any blind or deaf are allowed to euthanize, we are far from home,” the U.K.’s Telegraph newspaper reported doctors at the first hospital as saying. “I do not think this was what the legislation meant by ‘unbearable suffering.’”

However, the twins found other doctors willing to help them commit suicide in nearby Brussels. Wim Distelmans, one of the leading champions of Belgium’s euthanasia legislation, was one of the doctors who assessed their psychological suffering.

“It’s the first time in the world that a ‘double euthanasia’ has been performed on brothers,” he told reporters. “There was certainly unbearable psychological suffering for them. Though, of course, it is always possible to stretch the interpretation of that. One doctor will evaluate differently than the other.”

The case adds to a string of reports that vindicate euthanasia opponents’ fears about the law’s “slippery slope.” Last year, Belgian surgeons admitted to harvesting organs from at least four euthanasia patients. The death of a long-term prisoner by euthanasia was leaked to a Belgian politician, and, in the spring, a right-to-die group launched a mobile euthanasia program aimed at helping to kill the people turned down by their doctors, especially those with mental illnesses such as chronic depression and those with early dementia.

“Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick or dying persons,” the Catechism of the Catholic Church states. “It is morally unacceptable. Thus an act or omission which, of itself or by intention, causes the death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his creator.”

It goes on to say, “The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded. Discontinuing medical procedures that are burdensome, dangerous, extraordinary or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘overzealous’ treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted” (2277-2278).

Euthanasia Expands

Euthanasia cases have risen sharply in Belgium, growing 18% in 2011 to 1,133 (not including physician-assisted suicides in which the patient swallows lethal medicine himself rather than has it administered directly by medical personnel, so-called “slow euthanasia” in which terminally ill patients are dehydrated and drugged to hasten death, or unreported numbers.)

Dr. Peter Saunders, CEO of the U.K.-based Christian Medical Fellowship (CMF) and campaign director of the anti-euthanasia group Care Not Killing, points to reports that as many as half of Belgian euthanasia cases go unreported, and as many as a third are involuntary. A recent poll of Belgian pro-euthanasia nurses found half admitted to having killed people who did not request it (though it is illegal for nurses to perform euthanasia at all).

Last spring, the European Institute for Bioethics (IEB) published a report marking the 10-year anniversary of the euthanasia law. It noted the Belgian government’s toothless oversight. In more than 5,500 cases of euthanasia, there was not a single case investigated, and there was a “total absence of any sanctions” in the most suspect cases, the report said.

The report described a “trivialization” of euthanasia in Belgium. “Initially legalized under very strict conditions, euthanasia has gradually become a very normal and even ordinary act to which patients are deemed to ‘have a right.’”

Even so, the case of the Verbessem brothers “shocked the public, who didn’t realize that euthanasia is permitted when death is not imminent,” Carine Brochier, a project manager at IEB in Brussels and one of the report’s authors, told the Register.

But acclimatization to such deaths is well under way, she added. “People are so afraid of pain and suffering and infirmity. And [right-to-die advocates] have turned it into the only way to die in these circumstances.”

“It’s all made to sound so nice and serene,” Brochier said, citing the case of the twins. “A cup of coffee and a little wave ‘bye-bye.’ I cannot believe it was so painless for the mother of these twins. What was she suffering? It is very macabre.”

Killing the Vulnerable

Brochier said her organization is now monitoring a growing illegal trend to euthanize handicapped newborns and incompetent adults.

The proposed new legislation will make such cases legal and perhaps, with time, ordinary as well. But it goes a step further in proposing to disallow institutional conscientious objection. Catholic hospitals, if the law passes, would not be allowed to prohibit doctors from committing euthanasia. It would also make it compulsory for doctors who oppose euthanasia to refer patients seeking suicide to a willing doctor.

“These latest developments are a chilling reminder of how incremental extension will happen inevitably once the law changes and the public conscience is eroded,” said the CMF’s Saunders.

Still, there is little evidence that Belgium’s easy euthanasia is dissuading legislators in other regions. The government of the Canadian province is considering labeling euthanasia “medical treatment,” though the Montreal Gazette assured readers in January that restrictions will be “much tighter than in Oregon or Belgium.”

And, on Feb. 7, The Associated Press reported, the Health and Senior Services Committee of the New Jersey General Assembly voted 7-2 in favor of a bill now before the state Legislature to authorize doctor-assisted suicide. If the bill is passed into law by New Jersey legislators, the state would become the third U.S. state to allow euthanasia, along with Oregon, Washington and Montana.

New Jersey’s proposed legislation is modeled on the bills enacted by Oregon in 1994 and by Washington in 2008. Doctor-assisted suicide was legalized in Montana by a 2009 court ruling.

American euthanasia opponent Wesley Smith reported Feb. 10 about a shocking new case in Belgium involving a female psychiatric patient suffering from anorexia nervosa, who was killed by her current psychiatrist after being sexually abused by her previous psychiatrist.

“That’s why they call it the culture of death,” Smith commented at the conclusion of his Feb. 10 blog post about the Belgium woman’s death. “And it is steaming our way.”

‘Hurry Up and Die’

In other regions with low birth rates, unprecedented demographic changes are also putting euthanasia on the agenda. Japan’s finance minister, Taro Aso, bluntly captured the pro-euthanasia spirit when he told a meeting of the National Council on Social Security in January that his country’s elderly and “tube people” should “hurry up and die” to cut their medical expenses.

“Heaven forbid, if you are forced to live on when you want to die,” Aso said. “I would wake up feeling increasingly bad knowing that [treatment] was all being paid for by the government.”

People behind the groundswell of support for euthanasia should “wake up and see the future,” Sylvia Ann Hoskins, a retired professor of nursing and moral theology in Scotland told the Register. Referring to the Belgian twins, she said, “They were failed. They should have been helped; and, instead, they were dispensed with by people who said, ‘We agree with you. Your life is of no value. You should be killed.’”

Once euthanasia is legalized, critics note, there is little recourse for people to protect themselves from those powers, whether they want euthanasia or not.

Said Hoskins, “Do you want your doctors and nurses as legal hired assassins for the government? Think again.”